Medical Procedures and Autism

Introduction

We define medical procedures as any medical activities or processes that are designed to treat people autistic people - other than the activities and processes found in standard health care.

Most of the medical procedures in this section are currently being used in an alternative or 'off-label' way, that is, they are not accepted as standard health care practice by most health care professionals.

For example, some people are using cell therapy to tackle a variety of metabolic problems - such as oxidative stress. Other people are using biofeedback to help autistic people to monitor and control their own body functions, such as heartbeat.

Evidence

Some autistic people may have one or more physiological problems but it is unclear how many autistic people have these problems. It is also unclear if these problems cause or worsen the features of autism and related issues, if they arise because of the autism, or if they are completely unrelated to the autism. Most medical procedures currently have very little high-quality research evidence supporting them when they are used as alternative or ‘off-label’ treatments for autistic people. Research shows that some medical procedures (such as hyperbaric therapy) are not effective interventions for the treatment of autistic people.

Risks and safety

Most medical procedures carry some risk and this risk is likely to be higher when that procedure is used in an off-label way to treat autistic people, mainly because of the lack of regulation and agreed protocols. Some off-label medical procedures such as chelation may pose significant health risks to some individuals on the autism spectrum

Biofeedback

Biofeedback is the general term for any therapeutic intervention that uses medical equipment to monitor a body function that is otherwise outside of our awareness. A blood pressure cuff, a thermometer, a PET scan are all medical devices that can be used for biofeedback interventions.

There are several specific types of biofeedback including

Electromyogram (EMG). This measures muscle activity and tension. It may be used for back pain, headaches, anxiety disorders, muscle retraining after injury, and incontinence.

Heart rate variability (HRA or HRV) biofeedback. This measures heart rate. It may be used for anxiety, asthma, chronic obstructive pulmonary disease (COPD), and irregular heartbeat.

Neurofeedback training (also known as EEG biofeedback or electroencephalography biofeedback) is a type of biofeedback training. Neurofeedback training is designed to train individuals to enhance poorly regulated brainwave patterns by using sophisticated computer technology.

Some people believe that some forms of biofeedback, such as neurofeedback training, can be used to teach autistic people to overcome problems such as anxiety or poor attention etc.

Please Note

The National Institute for Health and Care Excellence recommended

'Do not use neurofeedback to manage speech and language problems in children and young people with autism.'

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Cell Therapy

Cell therapy (also known as cellular therapy or stem cell therapy) includes a variety of procedures in which processed tissue from animal embryos, fetuses, or organs is injected into the body or swallowed. The processed tissue is designed to replace or regulate the existing cells in the body.

Cell therapy is being used to treat a range of diseases, conditions, and disabilities including Parkinson’s disease, motor neurone disease, spinal cord injury, burns, heart disease, diabetes, and arthritis.

Some people think that cell therapy can provide various benefits to autistic people by helping to regulate the cells in their bodies. They think that cells could be designed to target specific functions within the body of autistic people, including abnormal neurotransmitter regulation, activated microglia, mitochondrial dysfunction, blood-brain barrier disruptions, and chronic intestinal inflammation.

Please Note

According to the International Society for Stem Cell Research: "Cell transplantation is a relatively new technology and the appropriate laws and regulations may not have been developed or applied to the field. Laws and regulations vary from country to country. Depending on the country and the nature of the procedure, there may be no laws restricting stem cell treatments, making them simply unregulated."

The use of cell therapy can be painful, distressing and potentially hazardous depending on how it is administered. We have seen reports which suggest that cell therapy can lead to significant damage, including death, in some individuals

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Chelation

Chelation (also known as detoxification or detox) is a medical procedure used to remove toxic substances (such as heavy metals like mercury or lead) from the body.

Chelation involves using one or more ‘chelators’ – chemicals such as DMSA, DMPS, EDTA, or N-acetylcysteine – to remove the toxic substances from the body.

Some people think that the symptoms of autism and/ or related problems (such as challenging behaviours) are caused by or worsened by toxic substances. They also think that those symptoms can be reduced through the use of chelation. They think that chelation may be of use to anyone on the autism spectrum who has abnormal levels of heavy metals in their bodies.

Please note

The National Institute for Health and Care Excellence advised: "Do not use [chelation] to manage autism in any context in children and young people."

Chelation can pose very serious risks. For example, according to one review, "The chemical substances utilised in chelation treatment have a myriad of potential and potentially serious, side effects, including fever, vomiting, diarrhea, loss of appetite, hypertension, hemorrhoid symptoms, metallic taste, hypotension, cardiac arrhythmias, hypocalcemia, the latter of which can in turn cause fatal cardiac arrest. In 2005, for example, a five-year-old boy with ASD died from cardiac arrest caused by hypocalcemia while receiving intravenous chelation. The potential safety risks associated with chelation recently resulted in a suspension of a clinical study of chelation treatment for autism. Additional safety issues arose from a rodent study that found lasting cognitive impairment."

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Hyperbaric Therapy

Hyperbaric therapy is the medical use of oxygen at a higher than atmospheric pressure. The oxygen is administered to the individual in a pressurised chamber, with the goal of increasing oxygen absorption in bodily tissue.

It is normally used for the treatment of conditions such as embolisms, decompression sickness or carbon monoxide poisoning.

Some people think that autistic people suffer from a range of metabolic problems, such as oxidative stress – physiological stress on the body caused by the cumulative damage done by free radicals inadequately neutralised by antioxidants. They think that this may cause many of the problems found in autistic people, such as poor eye contact, poor socialisation and lack of attention.

They think that hyperbaric therapy can be used to reduce oxidative stress, leading to a reduction in those behavioural problems

Please Note

The National Institute of Health and Clinical Excellence (NICE) made the following recommendations:

"Do not use hyperbaric oxygen therapy for the management of core symptoms of autism in adults."

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Transcranial Stimulation and Autism

Transcranial stimulation describes a number of different treatments which use painless electro-magnetic fields to stimulate nerve cells in the brain.

Transcranial direct current stimulation (tDCS), is a non-invasive, painless brain stimulation treatment that uses direct electrical currents to stimulate specific parts of the brain. A constant, low intensity current is passed through two electrodes placed over the head which modulates neuronal activity. There are two types of stimulation with tDCS: anodal and cathodal stimulation. Anodal stimulation acts to excite neuronal activity while cathodal stimulation inhibits or reduces neuronal activity.

Transcranial magnetic stimulation (TMS) is a procedure that uses magnetic fields to stimulate nerve cells in the brain. A large electromagnetic coil is placed against the scalp near the forehead. This creates painless electric currents that stimulate the brain. TMS is commonly used to treat mood disorders, such as depression. However some researchers believe it could be useful in the treatment of some of the problems faced by some autistic people.